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By analysing the similarity between defense qi and leukocytes in terms of function， site of action， and circadian rhythm， it is proposed that in traditional Chinese medicine （TCM）， the pathogenesis of leukopenia is defense qi deficiency. By analyzing the relevant discussions on the generation and transmission of defense qi in TCM classics， it is believed that the original qi in lower jiao （焦） is the source of defense qi， while the water and grain qi in middle jiao enriches defense qi， and the upper jiao transmits and distributes defense qi to the whole body. Therefore， when treating leukopenia after chemotherapy with TCM， Guilu Erxian Gelatin （龟鹿二仙胶） and Yougui Pill （右归丸） are often used to tonify the kidney and supplement essence， and moxibustion at Guanyuan （CV 4） and Qihai （CV 6） is usually accompanied to replenish the original qi in lower jiao and enrich the source of defense qi. Guipi Decoction （归脾汤）， Buzhong Yiqi Decoction （补中益气汤）， Shenling Baizhu Powder （参苓白术散）， and Sijunzi Decoction （四君子汤） are often suggested to strengthen spleen and replenish qi， in combination with moxibustion at Zhongwan （CV 12） and Zusanli （ST 36） to transport the spleen and stomach in the middle jiao to enrich the defense qi. Modified Guizhi Decoction （桂枝汤） to harmonize nutrient and defensive aspects is often used， and moxibustion at Dazhui （GV 14） and Feishu （BL 13） or scraping is added to dredge the striae and interstice in the upper jiao and promote transmission and dissemination of the defense qi. Considering the whole process of generation and distribution of defense qi， it is suggested to choose the most appropriate treatment modality flexibly， and combine internal treatment with external treatment， in order to provide ideas for the treatment of leukopenia in tumour patients.
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Objective:To study the past 10 years' experiences of neonatal hydrocephalus in a single-center.Methods:From January 2010 to December 2019, clinical data of infants with hydrocephalus admitted to Neonatology Department of our hospital were retrospectively analyzed. The infants were assigned into different groups according to gestational age, different etiologies and treatments. Their clinical characteristics and outcomes were compared.Results:A total of 223 infants with hydrocephalus were included. 136 (61.0%) infants were in the preterm group and 87 (39.0%) in the full-term group. The incidence of post-intracranial hemorrhage (ICH) hydrocephalus in preterm infants was significantly higher than full-term infants ( P<0.001). According to the etiologies, 58 infants (26.0%) had congenital hydrocephalus (congenital group), 82 cases (36.8%) developed post-ICH hydrocephalus (ICH group), 48 cases (21.5%) had post-CNS-infection hydrocephalus (infection group) and 35 cases (15.7%) had post-ICH+CNS-infection hydrocephalus (ICH+infection group). The incidences of perinatal asphyxia, neonatal resuscitation and endotracheal intubation within 3 d after birth in the ICH group were significantly higher than the other groups ( P<0.05). Among the four groups, the infection group had the highest incidence of neonatal sepsis, the congenital group had the highest incidence of patent ductus arteriosus and the ICH group had the highest incidence of respiratory diseases (all P<0.05).137 cases (61.4%) received non-surgical therapy, 48 cases (21.5%) had temporary drainage, 37 cases (16.6%) with permanent shunt and 1 case (0.4%) intracranial hematoma removal. The congenital group and ICH group with permanent shunt showed significantly higher rate of improvement than temporary drainage group and non-surgical group ( P<0.001). Conclusions:The main etiologies of neonatal hydrocephalus are ICH and CNS infection. The incidence of post-ICH hydrocephalus in premature infants was quite high. Hydrocephalus of different etiologies have different comorbidities. Maternal and infant care during pregnancy and delivery, prevention of neonatal sepsis and ICH are crucial in the prevention of hydrocephalus. More studies are needed for better treatment.
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Objective:To explore the types of venous access, indwelling time and the correlation with catheter-related bloodstream infection (CRBSI) of very and extremely low birth weight infants (VLBW & ELBW) in NICU.Methods:The self-designed venous access data collection form was used to collect the venous access data of VLBW & ELBW infants who were admitted to NICU of Children′s Hospital of Fudan University from January to December 2019. SPSS 22.0 software was used for data analysis, description and binary Logistic regression analysis.Results:A total of 218 cases were collected, including 9 cases of peripheral intravenous (PIV), 30 cases of PIV+ umbilical vein catheter (UVC), 43 cases of PIV+PICC, 136 cases of PIV+UVC+PICC. The average indwelling time of UVC was 6 days, the average indwelling time of PICC was 22 days. There were 23 cases (10.55%) got CRBSI and 195 cases (89.45%) without CRBSI. Binary Logistic regression analysis showed that birth weight ( OR=1.003, 95% CI 1.000-1.006, P<0.05) and combination form of venous access ( OR=0.139, 95% CI 0.023-0.834, P<0.05) of VLBW & ELBW infants were associated with CRBSI. Conclusions:In NICU, PIV, UVC and PICC are the three main ways to indwell venous access for VLBW & ELBW infants. The occurrence of CRBSI is closely related to the type and combination of indwelling venous access.
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Objective: To investigate influencing factors of early neurological deterioration (END) in acute cerebral infarction patients after intravenous thrombolysis. Methods: From March to August in 2018,a total of 139 consecutive acute cerebral infarction patients receiving intravenous thrombolysis within 4.5 h after onset in Department of Neurology of Xuanwu Hospital, Capital Medical University were recruited These patients included 116 males and 23 females. According to the presence of END after intravenous thrombolysis, the patients were divided into the END group (n =25) and the non-END group (n = 114). Baseline and clinical data were collected and compared between the two groups,including age,sex,past medical history (hypertension,diabetes,coronary heart disease,congenital heart disease,atrial fibrillation,hyperlipidemia, ischemic stroke [cerebral infarction, transient ischemic attack]), smoking, the National Institute of Health Stroke Scale (NIHSS), low-density lipoprotein cholesterol, blood glucose, blood pressure, proportion of anterior circulation infarction and the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Multivariate logistic regression analysis was performed for END incidence of these patients with the parameters of P 0. 05). (4) The large-artery atherosclerosis rate of the END group was significantly higher than that of the non-END group (76. 0% [19/25]vs. 45. 6% [52/114],χ2 =7. 576, P0.05). Conclusion Large-artery atherosclerosis in TOAST classification can increase the risk of END after intravenous thrombolysis in patients with acute cerebral infarction.
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Objective To study the clinical effect of evidence-based prevention strategies of ventilator-associated pneumonia (VAP) in newborns with endotracheal intubation in neonatal intensive care unit (NICU).Method A retrospective analysis was carried out in neonates undergoing mechanical ventilation,who were admitted to the NICU of the hospital from 2016 to 2017.Intubated newborns from January 2016 to December 2016 were conducted with traditional method of preventing VAP and included as control group.While intubated newborns admitted from January 2017 to December 2017 with newly developed evidence-based prevention strategy for VAP were included as observation group.The positive rates of culture from swab or sputum or endotracheal intubation tube ends obtained within 48 hours after intubation and 48 hours after extubation were compared between groups.The neonates whose swab or sputum culture was negative before intubation were included.The positive rate was presented as the number of positive cases/1 000 intubation days.Result A total of 1 221 intubated infants were included,with 632 cases in the control group which were intubated 798 times,and 589 cases in the observation group which were intubated 720 times.The gestational age and birth weight of the observation group was lower than the control group.The rate of extremely low birth weight infant of the observation group was higher than that of the control group.The mechanical ventilation days were also longer in the observation group.The differences were statistically significant (P ＜ 0.05).In the control group,the number of positive cases was 112 and the total intubation days were 3 079 days,the positive rate was 36.4 cases/1 000 intubation days.In the observation group,the number of positive cases was 72 and the total intuhation days were 3 475 days,the positive rate was 20.7 cases/1 000 intubation days.The positive rate of observation group was lower than the control group,the differences was statistically significant (x2 =4.060,P =0.044).Conclusion Evidence-based neonatal VAP bundle can reduce the invasion of respiratory pathogenic bacteria in NICU.In the future work of NICU nursing,we should use bundle strategy to care for babies more and more,and the bundle should be supported by evidence.
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Objective To investigate the incidence of the peripherally inserted central catheter (PICC) complications in neonates. Methods A retrospective analysis of PICC in 201 cases in our neonatal intensive care unit (NICU) from January 2015 to October 2016, who were divided into the central group and non-central group according to the position of the catheter tip. Compare unplanned extubation rate, catheter-related bloodstream infection rate, catheter indwelling time of PICC catheter and removing reasons between these two groups. Results One hundred and sixty-five cases in central group and thirty-six cases in non-central group. The unplanned extubation rate of the central group was 18.2% (30/165) while 22.2% (8/36) of non-central group, the difference wasnot statistically significant (χ2=0.315, P=0.639). The difference of the catheter-related bloodstream infection rate (P=0.471), the catheter indwelling time and removing reasons between these two groups were not statistically significant(P>0.05). Conclusions Even if the position of PICC tip is not in superior or inferior vena, it still can be used in neonatal population, but should pay attention to safe medical care.
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Objective To investigate the incidence and clinical presentation of breast milk transmitted cytomegalovirus (CMV) infection among preterm infants with birth weight≤1500 g.Methods Preterm infants enrolled in this study met the following inclusion criteria: birth weight≤1500 g, fed with CMV-positive breast milk and admitted into Neonatal Intensive Care Unit of Children's Hospital of Fudan University within 72 hours after birth from October 2015 to July 2016. And those with congenital digestive tract malformation or congenital CMV infection were excluded. Breast milk and infants' urine samples were regularly screened for CMV DNA by fluorescent quantitative polymerase chain reaction. Symptoms and laboratory findings in infants with CMV infection transmitted via breast milk were documented and analyzed. Differences in relevant parameters were analyzed usingChi-square test, Fisher's exact test,t test or Mann-WhitneyU test where appropriately.Results Sixty preterm infants breastfed with CMV DAN-positive milk were recruited. Among them, 19 (31.7%) developed breast milk-acquired CMV infection as their urine samples were positive for CMV DNA, while the others were negative for CMV DNA (infected group:n=19; non-infected group:n=41). The average CMV copies in breast milk, gestational age and birth weight of the infected group were all significantly higher than those of the non-infected group [3.76 (3.18-4.50) vs 3.47 (3.00-4.88) Log10 copies/ml,Z=-2.042;(30.4±2.1) vs (28.4±2.3) weeks,t=3.175; 1290 (750-1500) vs 1110 (575-1480) g,Z=-2.837; all P0.05]. Four infants (21.1%, 4/19) had severe organ damage and/or positive IgM antibodies to CMV in serum, and were treated with antiviral therapy. Two had mild symptoms and were not given antiviral therapy. All of the six symptomatic infants were followed-up for one to six months, during which time the complete blood cell count and results of biochemical test and fundus examination were back to normal.Conclusions The incidence of breast milk-acquired CMV infection among preterm infants with birth weight≤ 1500 g was 31.7%, and no severe symptoms were reported in this study.
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To study the functions of human Fibroblast growth factor receptor 2IIIc (FGFR2IIIc) gene in cancer cells, breast cancer cells MDA-MB-231 were infected by recombinant adenoviruses containing FGFR2IIIc and its S252W mutant, respectively. FGFR2IIIc gene was amplified from an existing plasmid and its S252W mutant was obtained by overlapping extension PCR. These two genes were separately cloned into the adenoviral shuttle plasmid pAdTrack-CMV, confivmed by DNA sequencing linearized, and co-transformed into Escherichia coli BJ-5183 with the adenoviral vector pAdEasy-1. The resulting recombinant expression vectors Ad-FGFR2IIIc and Ad-FGFR2IIIcS252W were linearized and transfected into HEK293A cells to get adenoviral particles. GFP was used to verify the gene expression. The recombinant adenoviral particles were harvested, titrated, and then infected MDA-MB-231 cells. The expression of FGFR2IIIc and its S252W mutant were examined by RT-PCR and Western blotting, and the effect of these recombinant adenoviruses on MDA-MB-231 cell proliferation was analyzed by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and flow cytometry. The results showed the recombinant adenoviral particles could infect MDA-MB-231 cells and express the target proteins. MTT showed that both FGFR2IIIc and its S252W mutant inhibited MDA-MB-231 cell proliferation, but the mutant was more effective. Flow cytometry showed that both FGFR2IIIc and its S252W mutant arrested MDA-MB-231 cell cycle at G0/G1 phase, resulting in low cell proliferation.
Subject(s)
Female , Humans , Adenoviridae , Genetics , Metabolism , Antineoplastic Agents , Pharmacology , Breast Neoplasms , Metabolism , Pathology , Cell Line, Tumor , Genetic Vectors , Genetics , Mutant Proteins , Genetics , Receptor, Fibroblast Growth Factor, Type 2 , Genetics , Recombinant Proteins , Genetics , Pharmacology , TransfectionABSTRACT
This study examined the effects of ursolic acid (UA) on the proliferation and apoptosis of a human ovarian cancer cell line, CAOV3. The CAOV3 cells were cultured in the RPMI 1640 media and treated with different concentrations of UA (0, 10, 20, 40 mumol/L). The proliferation rate of the CAOV3 cells was determined by MTT assay. The apoptosis rate was measured by flow cytometry. ERK activity was detected by immunoprecipitation and the expressions of p-ERK1/2, MKP-1, Bax and Bcl-2 by Western blotting. The results showed that the proliferation rate was significantly decreased in the cells treated with UA as compared with that in the non-treated cells (P<0.05). The intracellular ERK activity and p-ERK1/2 expression were also reduced in the UA-treated cells, while the MKP-1 expression was elevated. Moreover, the apoptosis was found in the CAOV3 cells exposed to UA; the Bax expression was increased and the Bcl-2 expression decreased. The apoptosis rate in the UA-treated cells was much higher than that in the non-treated cells (P<0.05). It is concluded that UA can inhibit the proliferation of CAOV3 cells by suppressing the ERK activity and the expression of p-ERK1/2. And it can also induce the apoptosis of the CAOV3 cells by up-regulating the Bax expression and down-regulating the Bcl-2 expression.